SETTING: All 15 district hospitals of the West Province of Cameroon, between July 1997 and June 1998.OBJECTIVE: To determine the prevalences of initial and acquired resistance to the main anti-tuberculosis drugs 2 years after the implantation of a tuberculosis control programme in the province.METHODS: A total of 615 adults consecutively admitted to the 15 district hospitals with sputum smear-positive pulmonary tuberculosis were systematically studied. Sputum specimens collected from each patient were cultured on Löwenstein-Jensen medium. Testing of susceptibility to the major anti-tuberculosis drugs was performed by the indirect proportion method.RESULTS: Growth of Mycobacterium tuberculosis complex strains was obtained from specimens of 566 (92%) of the 615 patients. The overall resistance rate (one or more drugs) was 26.9%, with initial resistance being 19.7% (86/437) and acquired resistance 51.1% (66/129). Initial resistance to isoniazid was the most common (12.1%), followed by streptomycin (11.7%), ethambutol (2.5%) and rifampicin (2.1%). Initial resistance was noted as 13.5% to one drug, 4.3% to two, 1.1% to three and 0.7% to four. Acquired resistance to isoniazid was the most frequent (41.1%), followed by streptomycin (26.4%), rifampicin (14.7%) and ethambutol (9.3%). Acquired resistance was 25.6% to one drug, 14.7% to two, 7% to three and 3.9% to four.CONCLUSION: The proportion of resistant tuberculosis in the West Province is quite high. This underscores the need for the improvement of the control programme by introducing the DOTS strategy.

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